28.1 Physical Therapy Management of Concussion
Table of Contents

THE BASICS OF CONCUSSION

Abstract:

Concussions are mild traumatic brain injuries associated with functional rather than structural brain changes. Concussions are heterogenous, and can present with an array of clinical signs and symptoms that can be clustered into distinct profiles. Recovery from concussion is influenced by a variety of known risk factors, several which may be influenced by treatment. Because of its prevalence, concussion is frequently encountered by physical therapists in clinical practice. The role of physical therapists in the evaluation and management of patients following a concussion is integral, due to cervical, balance, vestibular, oculomotor, and return to sport concerns that often accompany this injury. Management of concussion involves a continuum of care, including detection, rehabilitation, return to participation, and prevention. Ensuring complete neurologic recovery before return to sport or high-risk activity is an overarching concept to avoid potential negative consequences of concussion.

Keywords:​

pathophysiology, risk factors, return to play, prevention

References:

Abstract:

There is increasing support that active management, rather than rest, may be more effective in improving the recovery course following concussion. Treatment options include cervical, exertion, vestibular, and vision rehabilitation; behavioral regulation; activity modification; and pharmacologic intervention. Because concussion is a heterogenous condition, identifying concussion subtypes, or profiles, can assist in management. Physical therapists, as part of a multidisciplinary team, play an integral role in implementing many of the treatments that can benefit the various profiles of concussion. In addition, physical therapists also play a role in identification, referral, education, and behavioral management surrounding all clinical presentations. Additional research is needed to provide empirical support for the application of various treatment regimens following concussion.

Keywords:​

concussion, rest, treatment, rehabilitation

References:

Abstract:

There is increasing support that active management, rather than rest, may be more effective in improving the recovery course following concussion. Treatment options include cervical, exertion, vestibular, and vision rehabilitation; behavioral regulation; activity modification; and pharmacologic intervention. Because concussion is a heterogenous condition, identifying concussion subtypes, or profiles, can assist in management. Physical therapists, as part of a multidisciplinary team, play an integral role in implementing many of the treatments that can benefit the various profiles of concussion. In addition, physical therapists also play a role in identification, referral, education, and behavioral management surrounding all clinical presentations. Additional research is needed to provide empirical support for the application of various treatment regimens following concussion.